HomeMy WebLinkAbout07-10-13 � 15�561�1N0
REV-1500 EX (�2-11)(FI)
PA Department of Revenue oFFICIaL USE dNLY
BureauoflndividualTaxes WHERITANCETAXRETURN CountyCode Year FileNumher
PO BOX 280601 2 y 1. 2 0 8 D 6
___ _ Harrisburq PA 17128.0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
SoCial SeCUfity Nutnbef DBte of Death MMDDYYYY Date Of Birth MMDDYYYY
0 7 1 0 2 0 1 2 1 0 � 8 1 9 5 S
DecedenHs Last Name Suffx DecedenYS First Name MI
M C G I L L V R A Y F R E D
� (If Applicable)Enter Survivi�g Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M�
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Retum Q 2. Supplemental Retum � 3. Remainder k2etum(Date of Qeath
Priorto 12-13-82)
� 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Retum Required
death after 12-12-82)
� 6.Decedent Died Testete � 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wilq (Attach Copy of Trust.) ,
� 9. Litigation Proceeds Received � �0.Spousal Poverty Credit(Date of Death � 11. Election to Tax under Sec.9113{A)
Behveen 12-31-91 and 1•1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SNOULD BE DIRECTED T0:
Name Daytime Telephone Number
H U B E R T X - G I L R 0 Y 7 1 7 2 4-,3 3 3 4 1
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f—�� _. � �1-��
�Q(STER�F NL(ILLS U��Y I
First Line of Address m = n ~ --r �
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1 0 E A S T H I G H S T R E E T b' N � � � �
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Second Line of Address "� c'� c; � � �
� �, T � _. '.'�
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77 C-� t"' (T
City Of Po51 OffiCB SfafB ZIP Code ' � DATE F ED� p�
A � -rl
C A R L I S L E P A 1 7 0 1 3
CorrespondenPSe-mailatld�ess: HGILROY(a�MARTSONLAW.COM
Under penalties of perjury,I declare that I have ezaminetl this retum,inclutling accompanying schedules and statements,antl fo the best of my knowledge and belleF,
it is true,correct antl complete.Declaration of preparer other than ihe personel representative is basetl on all in(ormation of which p�eparer has any KnowleAgg.
StGNAATURA E OF���R4E�PONSIBLE FOR FILING RETURN A qK��
y�>. �'� t �
ADD SS
122 BUTTE M K ROAD NEWVILLE PA 17241
SIGft1�J� F P PA OTHER THAN REPRESENTATIVE ^ D T �
(/D` i j
ADDRESS
1D EAST HI STREET CARLISLE PA 17013
PLEASE USE ORIGINAI FORM ONLY
Side 1
� 150561014� 1505610140 ���
J 1505610240
REV-1500 EX (FI) DecedenPs Social Security Number
oecede�rsName: FRED MC6ILLVRAY
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . .. ..... . . . . . . . . . . . . . 1. � • � �
2. Stocksand Bonds(Schedule B) ... . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . 2_ � . 0 0
3. Closety Held Corporetion, Partnership or Sole-Proprietorehip(Schedule C) . . . . . 3. •
4. Mortgages and Notes Receivable(SChedule D) . . . . . . . . . . . . . . . . .. . . . . . . . . 4. •
5. Cash,Bank Deposits and Miscellaneous Personal Properly(Scheduie E). . . . . . . 5. � • 0 0
6. Jointly Owaed Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. � , � �
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. � , � �
8. ToWI Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. O , 0 0
9. Funeraf Expenses and Atlministrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. � . 0 0
10. Debts of Decedent,Mort a e Liabilitles, and Liens Schedule I 10. 1 7 6 1 3 . 5 7
9 9 ( ) . . . . . . . . . . . . .
ry�. Sotal Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 7 6 1 3 . 5 7
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. ' 1 7 6 1 3 . 5 7
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been matle(Schedule J) . . . . . . . . . . .... .. . . . . . . 13. .
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . .... . . .. . . . . .. 14. - 1 7 6 1 3 . $ 7
TAX CALCULATIOP!-SEE INS7RUCTIONS FOR APPLICABLE RATES
15. Amounf of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 _ � . � � 15. 0 . 0 �
16. Amount of l,ine 14 taxable
at lineal rate X.0_ � . 0 0 1 g, 0 . 0 �
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 ��. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0 �g. � . 0 0
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. O . O O
20. FILL lN THE OYAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 15�561�240 1505610240 J
REV-1572 EX+(12-72)
pennsylvania SCHEDULE I
�EPARTMENTOFREVENUE DEBTS OF DECEDENT�
wHeRiTnNCernxReruRN MORTGAGE LIABILITIES& LIENS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
FRED MCGILLVRAY 21 12 0806
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. Ed's Custom Milling,LLC,claim received after initia]filing of Inheritance Tax Return ]0,991.77
2. Franklin Feed& Supply Co.,claim received after initial filing of Inheritance Tax Return 6,621.80
TOTAL(Afso enter on Line 10,Recapitulation) $ �7,613.57
If more space is needed, insert additional sheets of the same size.